Metronidazole
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
Bacterial vaginosis is a complex vaginal syndrome characterized by decreased lactobacilli and the overgrowth of facultative and strictly anaerobic bacteria, including G. vaginalis, Prevotella spp., Bacteroides spp., Mobiluncus spp., anaerobic Gram-positive cocci, genital mycoplasmas, and, more recently recognized, Atopobium vaginae (Eschenbach et al., 1989; Thorsen et al., 1998; Ferris et al., 2004; Sobel, 2005). The treatment of bacterial vaginosis has been extensively reviewed by Koumans et al. (2002). Many studies have shown that oral metronidazole is effective for the treatment of bacterial vaginosis (Balsdon et al., 1980; Spiegel, 1987; Koumans et al., 2002). In randomized studies evaluating the use of oral metronidazole 400 mg two or three times daily for 5–7 days, or 500 mg two or three times daily for 7–10 days, cure rates of 80–92% were achieved (Koumans et al., 2002). The CDC recommend an oral regimen of 500 mg twice daily for 7 days, or metronidazole gel 0.75%, one full applicator (5 g) intravaginally, once daily for 5 days, or clindamycin cream 2%, one full applicator (5 g) intravaginally at bedtime for 7 days (Workowski and Bolan, 2015). Alternative regimes include oral tinidazole or oral clindamycin or intravaginal clindamycin ovules.
Tissue structure and physiology of the vulva*
Miranda A. Farage, Howard I. Maibach in The Vulva, 2017
Culture-independent methods have recently been applied to characterize vulvar microbiota. A pilot study in five women found a diverse microbiota on the vulva, including populations known to be commensals of the microbiota of the skin, colon, and vagina (69). A greater diversity of microbes inhabited the labia majora compared with the labia minora, although both sites had appreciable numbers of lactobacilli and strict anaerobes. No single species was common to all women. A study in 10 Japanese women compared the microbiota on the labia minora before and during menstruation. Twenty-two genera were represented (70). The genus Lactobacillus predominated in 7 out of the 10 women and Atopobium vaginae and Gardnerella vaginalis predominated in two others. Six of 10 women exhibited a significantly different profile of vulvar microbiota during menstruation.
Microbial Biofilms
Chaminda Jayampath Seneviratne in Microbial Biofilms, 2017
Biofilms are implicated in vaginal infections such as bacterial vaginosis and vulvovaginal candidiasis [143]. Bacterial vaginosis is the most common genital tract infection in women during their reproductive years. It is associated with serious health complications such as preterm delivery and sexually transmitted diseases [144]. Bacterial vaginosis is characterised by a reduction of beneficial lactobacilli and a significant increase in the number of anaerobic bacteria, including Gardnerella vaginalis, Atopobium vaginae, Mobiluncus spp., Bacteroides spp. and Prevotella spp., resulting in a thick multispecific vaginal biofilm, with G. vaginalis as the dominant player. Candida species are common inhabitants of the vagina, which can form biofilms leading to vulvovaginal candidiasis. C. albicans is the most commonly isolated species of Candida, followed by C. glabrata, from cervicovaginal swabs in vulvovaginal candidiasis [145].
Comparison of microbial profiles and viral status along the vagina-cervix-endometrium continuum of infertile patients
Published in Systems Biology in Reproductive Medicine, 2023
Mark Jain, Elena Mladova, Anna Dobychina, Karina Kirillova, Anna Shichanina, Daniil Anokhin, Liya Scherbakova, Larisa Samokhodskaya, Olga Panina
A comparison of the detection rates of each analyzed group or species of microorganisms and viruses is presented in Figure 2. Such pathogenic agents as Mycoplasma genitalium, Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, and Herpes simplex virus 2 were completely absent in all samples. Moreover, among 31 analyzed taxa 14 were detected in none of the studied samples. Therefore, only the remaining 17 taxa were subjected to further analysis. Paired cervical and vaginal samples differed significantly in the detection rates of 8/17 microorganisms (p < 0.05). At the same time, endometrium exhibited a quite distinct microbiological profile, being different (negatively) in the detection rates of 14/17 taxa (p < 0.05), except Candida spp. in which case significant differences were observed only compared to vaginal samples. Due to the generally lower microbiological diversity of the uterus, the detection of a certain taxon in the endometrium, but not in the lower parts of the reproductive tract, is of particular interest. In total, there were six cases fitting the above description: Cytomegalovirus (CMV) – 3 patients; Candida spp. – 1 patient; CMV + Candida spp. – 1 patient, Atopobium vaginae – 1 patient.
Derangements of vaginal and cervical canal microbiota determined with real-time PCR in women with recurrent miscarriages
Published in Journal of Obstetrics and Gynaecology, 2022
Canan Soyer Caliskan, Nazan Yurtcu, Samettin Celik, Ozlem Sezer, Suleyman Sirri Kilic, Ali Cetin
Table 2 includes the state of Enterobacterium spp., Streptococcus spp., Staphylococcus spp., Eubacterium spp., Sneathia spp./Leptotrihia spp./Fusobacterium spp., Megasphaera spp./Veilonella spp./Dialister spp., Lachnobacterium spp./Clostridium spp., Mobiluncus spp./Corynebacterium spp., Peptostreptococcus spp., and Atopobium vaginae in vaginal and cervical specimens obtained from healthy women and women with RM. Analyses of data regarding facultative anaerobic microorganisms related to AV revealed the following: (1) The rate of 1–10 and 10–100% total microorganisms detected (TMD) of Enterobacterium spp. in the vaginal and cervical specimens were significantly higher in women with RM compared with healthy women (76 vs. 28 and 72 vs. 28%, respectively; p < .05). (2) The rates of 1–10 and 10–100% TMD of Streptococcus spp. in the vaginal and cervical specimens obtained from healthy women and women with RM were found to be similar (Streptococcus spp.: 4 vs. 4 and 4 vs. 8%, respectively; p > .05). (3) The rates of 1–10 and 10–100% TMD of Staphylococcus spp. in the cervical specimens were significantly higher in women with RM compared with healthy women (20 vs. 12%; p < .05). However, the rates of 1–10 and 10–100% TMD of Staphylococcus spp. in the vaginal specimens obtained from healthy women and women with RM were found to be similar (0 vs. 0%, respectively; p > .05).
Related Knowledge Centers
- Anaerobic Organism
- Bacteria
- Bacterial Vaginosis
- Atopobiaceae
- Gram-Positive Bacteria
- Coccobacillus